Philippe Janne

Psychosomatics and Dermatology: Comparison between Objective Data and Subjective Impressions Given by Patients and Dermatologists

The authors wanted to assess the psychological part in the etiology of different skin diseases in adult outpatients in a dermatological university clinic. The other aim of this study was to explore the dermatologist’s perception of a psychological involvement in the etiology of some skin diseases. This was compared with the patients’ perception of it and with objective data obtained by self-rating questionnaires. 554 outpatients consulting for psoriasis, alopecia areata, eczema, and benign tumors were studied with multiple comparison statistics about family functioning, depression, tendency to complain, perceived stress, life events, and coping skills. When based on the dermatologist’s impression of a psychosomatic involvement, significant mean differences do exist about tendency to complain, depression, life events before the onset of the disease, and coping with the treatment. When comparing psoriasis, alopecia areata and eczema patients with patients consulting for benign tumor, significant differences are quite the same. According to the patients, life events with an impact on the onset of the disease happened during the last year for psoriasis and during the years before for alopecia areata. Only about 35% of patients with difficulties in family relationships and 48% of patients with depression are correctly recognized by dermatologists. They seem to be influenced by the patients’ assumptions and by the dermatological diagnosis. This suggests that patients who are not aware of a psychological influence in the etiology of their disease could not be recognized by the dermatologist and could thus not be treated optimally. The authors point out the necessity of better tools in order to recognize the psychological part in the etiology of skin diseases.

Rôle de l’attitude du conjoint sur les manifestations comportementales de la douleur chez le patient douloureux chronique: revue de la littérature et limites des investigations

RésuméPlusieurs auteurs ont souligné l’importance de la communication dans les comportements de patients douloureux chroniques. Cette communication est dirigée vers l’entourage: amis, praticiens mais surtout conjoint. Ce présent article met le doigt sur le fait que ces manifestations comportementales de douleur, si elles sont dirigées ne sont pas toujours centripètes mais également centrifuges.SummarySeveral searchers have outlined the importance of communication processes surrounding chronic pain patients, reaching friends, practioners but also and essentially husband or wife. The present paper shed some light on the fact that pain behaviour, when oriented, can have not only centripetal but also centrifugal effects.